A COMPARATIVE STUDY OF THE EFFICACY OF HAMSTRING STRETCHING AND STRENGTHENING EXERCISES IN IMPROVING FUNCTIONAL STATUS IN PATIENTS WITH CHONDROMALACIA PATELLA: A RANDOMIZED CLINICAL TRIAL

Background: Chondromalacia patella is a degenerative condition characterized by the softening and deterioration of the cartilage beneath the patella, leading to anterior knee pain and functional limitations. It commonly results from repetitive stress, overuse, misalignment, or muscular imbalances. Individuals with this condition often experience pain exacerbated by activities such as stair climbing, prolonged sitting, and heavy physical exertion. Effective rehabilitation strategies focus on strengthening or stretching the lower limb muscles to improve functional outcomes and alleviate symptoms. Objective: To evaluate and compare the effects of hamstring stretching and hamstring strengthening exercises on functional status in individuals with chondromalacia patella. Methods: A total of 40 diagnosed patients were enrolled in this randomized clinical trial, with 20 participants assigned to each group. Group A performed hamstring strengthening exercises, while Group B engaged in hamstring stretching exercises, both administered over four sessions within a two-week period. The Lower Extremity Functional Scale (LEFS) was used to assess functional outcomes at five time points: baseline, immediately after the first session, three days post-session, seven days post-session, and eleven days post-session. Data analysis was conducted using one-way repeated measures ANOVA and independent sample t-tests, with significance set at p<0.05. Results: Both groups exhibited significant improvements in lower extremity function (p<0.05). Group A's mean LEFS score increased from 27.60±11.35 at baseline to 36.15±11.38 at the final assessment. Group B demonstrated a greater improvement, with scores rising from 26.15±12.38 to 37.50±12.44. The mean functional improvement was significantly higher in Group B (11.30±1.22) compared to Group A (8.55±1.19), with a t-value of -7.22 (p<0.05). Conclusion: Hamstring stretching exercises resulted in superior functional improvements compared to hamstring strengthening exercises in individuals with chondromalacia patella. These findings suggest that flexibility-focused interventions may be more effective in enhancing lower limb function and should be considered in rehabilitation protocols.